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Additive prognostic value of high baseline coronary flow velocity to ejection fraction during resting
Angela Zagatina1, Olesya Guseva2, Elena Kalinina1
1Saint Petersburg State University Hospital, Saint Petersburg, Russia.
Insights
High coronary artery velocity during echocardiography predicts major adverse cardiac events (MACE) over three years. This assessment provides valuable prognostic information for identifying high-risk patients.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Tools
Background:
- Limited data exists on the prognostic significance of high coronary artery velocity detected via echocardiography.
- Coronary artery velocity assessment is not routinely used for long-term risk stratification.
Purpose of the Study:
- To investigate the three-year prognostic value of coronary velocity assessment in patients undergoing echocardiography.
- To determine if coronary velocity parameters can identify individuals at high risk for major adverse cardiac events (MACE).
Main Methods:
- A prospective study of 747 consecutive patients undergoing echocardiography.
- Coronary velocity was assessed using Doppler in the left main, anterior descending, or circumflex coronary arteries.
- Major adverse cardiac events (MACE) included death, myocardial infarction (MI), acute coronary syndrome (ACS), and/or revascularization.
Main Results:
- 192 patients experienced MACE during a median 36-month follow-up.
- High coronary velocity (>65 cm/s) in proximal segments was a strong independent predictor of death/MI/ACS (HR 4.7).
- Coronary flow velocity demonstrated additive prognostic value to ejection fraction for predicting MACE.
Conclusions:
- Coronary velocity parameters provide significant long-term prognostic information.
- This assessment can identify high-risk individuals among unselected patients undergoing echocardiography.
- Coronary velocity assessment is a valuable tool for risk stratification in cardiology.
Background:
There is a lack of information about the prognostic value of high velocity in coronary arteries during echocardiography. The present study was aimed at investigating the three-year prognostic value of coronary velocity assessment in all patients who were referred for echocardiography examination.
Methods:
The prospective study comprises 747 consecutive patients. Death, myocardial infarction (MI), acute coronary syndrome (ACS), and/or revascularisation were defined as major adverse cardiac events (MACE). Routine echocardiography was added with coronary velocity assessment in the left main, anterior descending, or circumflex coronary arteries by the Doppler method.
Results:
During a median follow-up of 36 months, 192 patients experienced MACE. Deaths occurred more frequently in patients with high local velocity in proximal left-sided segments vs. in middle left-sided segments vs. patients without high coronary velocity (9 vs. 3 vs. 1%, p < 0.0001). Death/MI/ACS occurred in 17 vs. 7 vs. 1%, p < 0.0001, respectively. Age (HR 1.04, 95% CI 1.00; 1.06; p < 0.04), a velocity more than 65 cm/s in any proximal segments of the arteries (HR 4.7, 95% CI 1.9; 11.9; p < 0.002), ejection fraction (HR 0.97, 95% CI 0.94; 0.99; p < 0.007) were strong independent prognostic predictors of death/MI/ACS. The maximal velocity of coronary flow velocity had a significant additive prognostic value to ejection fraction.
Conclusions:
The coronary velocity parameters give long-term prognostic information that can be used to identify persons with a high risk of MACE in consecutive non-selected patients.
